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AHIMA CDIP Exam Syllabus Topics:

AHIMA Certified Documentation Integrity Practitioner Sample Questions:

1. A clinical documentation integrity practitioner (CDIP) is reviewing an outpatient surgical chart. The patient underwent a laparoscopic appendectomy for acute gangrenous appendicitis. Which coding reference should be used for coding advice on correct assignment of the procedure code for proper ambulatory payment classification (APC) reimbursement?

A) O AMA CPT Assistant
B) AHA Coding Clinic for ICD-10-CM/PCS
C) The Merck Manual
D) O ICD-10-CM/PCS Codebook

2. Which factors are important to include when refocusing the primary vision of a clinical documentation integrity (CDI) program?

A) Benchmarks and case mix index
B) Diagnostic related groups and revenue cycle
C) Value and mission statements
D) Reporting and the use of technology

3. A modifier may be used in CPT and/or HCPCS codes to indicate

A) a service or procedure was increased or reduced
B) a service or procedure resulted in expected outcomes
C) a service or procedure was performed by one provider
D) a service or procedure was performed in its entirety

4. The clinical documentation integrity (CDI) manager is reviewing physician benchmarks and notices a low-severity level being measured against average length of stay.
What should the CDI manager keep in mind when discussing this observation with physicians?

A) The diagnosis with a higher degree of specificity has a lower severity of illness.
B) The indicator is a key factor of measurement for quality reports.
C) The query response rate directly correlates to quality reports.
D) The query rate is too high while the agreement rate is low.

5. A 27-year-old male patient presents to the emergency room with crampy, right lower quadrant abdominal pain, a low-grade fever (101° Fahrenheit) and vomiting. The patient also has a history of type I diabetes mellitus. A complete blood count reveals mild leukocytosis (13,000/microliter). Abdominal ultrasound is ordered, and the patient is admitted for laparoscopic surgery. The patient is given an injection of neutral protamine Hagedorn insulin, in order to normalize the blood sugar level prior to surgery. Upon discharge, the attending physician documents "right lower quadrant abdominal pain due to possible acute appendicitis or probable Meckel diverticulitis".
What is the proper sequencing of the principal and secondary diagnoses?

A) Acute appendicitis, Meckel diverticulitis, type I diabetes mellitus
B) Acute appendicitis, right lower quadrant abdominal pain, type I diabetes mellitus
C) Right lower quadrant abdominal pain, acute appendicitis, Meckel diverticulitis, fever, vomiting, leukocytosis
D) Right lower quadrant abdominal pain, fever, vomiting, leukocytosis

Solutions: